Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2004
Letter Case ReportsAbdominal wall mucormycosis after heart transplantation.
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J. Cardiothorac. Vasc. Anesth. · Dec 2004
Clinical TrialImproving glycemic control in the cardiothoracic intensive care unit: clinical experience in two hospital settings.
Recent studies suggest that strict perioperative glycemic control improves clinical outcomes after cardiothoracic surgery. However, optimal methods and targets for controlling blood glucose (BG) levels in this setting have not been established. Currently published intensive insulin infusion protocols (IIPs) have important practical limitations, which may affect their utility. In this article, the authors present their experience with a safe, effective, nurse-driven IIP, which was implemented simultaneously in 2 cardiothoracic intensive care units (CTICUs). ⋯ The IIP safely and effectively improved glycemic control in 2 CTICUs, with minimal hypoglycemia. Based on prior studies showing the benefits of strict glycemic control, the implementation of this IIP should help to reduce morbidity and mortality in CTICU patients.
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J. Cardiothorac. Vasc. Anesth. · Dec 2004
Alterations of mesenteric blood flow after cardiopulmonary bypass: a Doppler sonographic study.
Mesenteric ischemia after cardiopulmonary bypass is a serious complication associated with high mortality. It was the aim of this study to investigate mesenteric blood flow with the help of Doppler sonography in asymptomatic patients before and after cardiopulmonary bypass and cardiac surgery. ⋯ The postoperative changes in the flow velocities and the increases of the resistive and pulsatility index are indications of rigidity of the mesenteric vascular bed and decreased mesenteric perfusion after cardiopulmonary bypass.
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J. Cardiothorac. Vasc. Anesth. · Dec 2004
Predictors of atrial fibrillation after off-pump coronary artery bypass graft surgery.
Atrial fibrillation is the most common complication after coronary artery bypass graft surgery. This arrhythmia may lead to hemodynamic compromise, prolonged hospitalization, and increased risk for cerebral thromboembolism. Older age is the only variable consistently associated with the development of postoperative atrial fibrillation; however, no strong predictive model exists. The purpose of this study was to identify perioperative characteristics associated with new-onset atrial fibrillation in patients undergoing off-pump coronary artery bypass grafting. ⋯ Despite the less invasive approach, the incidence of postoperative atrial fibrillation is high after off-pump coronary artery bypass grafting. Older age, grafting of the ramus medianus, and a redo operation were predictors of new-onset postoperative atrial fibrillation. It is possible that left atrial stretching with heart dislocation during revascularization of the lateral wall could lead to postoperative atrial fibrillation.